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Characterizing COVID-19 clinical phenotypes and associated comorbidities and complication profiles
Elizabeth R Lusczek1, Nicholas E Ingraham2, Basil S Karam3
1Department of Surgery, University of Minnesota, Minneapolis, MN, United States of America.
Plos One
|March 31, 2021
Summary
Three distinct clinical phenotypes were identified in hospitalized coronavirus disease 2019 (COVID-19) patients, each associated with unique comorbidities and varying risks of complications and death. These COVID-19 phenotypes may guide personalized treatment strategies.
Area of Science:
- Infectious Diseases
- Internal Medicine
- Critical Care Medicine
Background:
- Hospitalized patients with coronavirus disease 2019 (COVID-19) exhibit heterogeneous outcomes.
- Identifying distinct clinical phenotypes is crucial for developing tailored therapeutic approaches and improving patient prognoses.
Purpose of the Study:
- To identify specific clinical phenotypes among hospitalized COVID-19 patients.
- To compare the admission characteristics and clinical outcomes associated with each identified phenotype.
Main Methods:
- Retrospective analysis of 1,022 hospitalized COVID-19 patients from March to August 2020 across 14 U.S. hospitals.
- Ensemble clustering applied to 33 variables within 72 hours of admission.
- Multinomial and multivariable regression models used to analyze comorbidities, complications, and outcomes by phenotype.
Main Results:
- Three distinct COVID-19 phenotypes (I, II, III) were identified, comprising 23.1%, 60%, and 16.9% of patients, respectively.
- Phenotype I was associated with higher odds of respiratory, renal, hepatic, metabolic, and hematological complications.
- Phenotypes I and II showed significantly increased hazard ratios for in-hospital mortality compared to Phenotype III.
Conclusions:
- Three clinical phenotypes of COVID-19 were identified, characterized by differences in comorbidities, complications, and outcomes.
- These phenotypes offer a framework for stratifying patients and potentially personalizing care.
- Further research is warranted to validate the clinical utility of these phenotypes in practice and clinical trial design.
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